Pharmacodynamic Effects of Vorapaxar in Patients With and Without Diabetes Mellitus

Pharmacodynamic Effects of Vorapaxar in Patients With and Without Diabetes Mellitus

Summary: Vorapaxar reduces thrombotic cardiovascular events at the expense of increased bleeding. However, the differential pharmacodynamic (PD) effects of vorapaxar according to diabetes mellitus (DM) status are unknown. Moreover, although withdrawal of aspirin has emerged as a bleeding reduction s...

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Bibliographic Details
Main Authors: Francesco Franchi, MD, Fabiana Rollini, MD, Victor Kairouz, MD, Jose Rivas Rios, MD, Andrea Rivas, MD, Malhar Agarwal, MD, Maryuri Briceno, MD, Mustafa Wali, MD, Ahmed Nawaz, MD, Gabriel Silva, MD, Zubair Shaikh, MD, Naji Maaliki, MD, Latonya Been, AAS, Jason Piraino, DPM, Andres M. Pineda, MD, Siva Suryadevara, MD, Daniel Soffer, MD, Martin M. Zenni, MD, Lisa K. Jennings, PhD, Theodore A. Bass, MD, Dominick J. Angiolillo, MD, PhD
Format: Article
Language:English
Published: Elsevier 2019-11-01
Series:JACC: Basic to Translational Science
Online Access:http://www.sciencedirect.com/science/article/pii/S2452302X19302256
Description
Summary:Summary: Vorapaxar reduces thrombotic cardiovascular events at the expense of increased bleeding. However, the differential pharmacodynamic (PD) effects of vorapaxar according to diabetes mellitus (DM) status are unknown. Moreover, although withdrawal of aspirin has emerged as a bleeding reduction strategy, the PD effects of stopping aspirin in patients treated with vorapaxar also are unknown. In this prospective PD investigation, vorapaxar was associated with reduced platelet-mediated thrombogenicity without affecting clot kinetics irrespective of DM status. However, platelet-mediated thrombogenicity increased after aspirin withdrawal, particularly among patients with DM. (Optimizing anti-Platelet Therapy In diabetes MellitUS-5 Study [OPTIMUS-5]; NCT02548650) Key Words: dual antiplatelet therapy, pharmacodynamics, platelets, thrombin, vorapaxar
ISSN:2452-302X

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